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Until recently, training of endoscopists was largely up to the local environment, often unstructured and only sporadically supervised. Consequently, there were large variations in the performance of endoscopy, and the quality of the service was very often too poor.1 During recent years, some countries have made great efforts to formalise and structure endoscopist training, often within the framework of continual quality improvement initiatives. This has led to impressive and sustained improvement in the quality of endoscopy services, as recently shown for colonoscopies in the UK.2
The number of procedures performed during training or practice has long been used as a measure of competency. Clearly, competency of technical skills is related to how often someone does something. Repetition (increasing the number of times one does something within a certain amount of time) is a well recognised tool of learning and …
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